Your Voice and Pelvic Floor

You know the familiar adage, “as above, so below?” There are many physical and spiritual interpretations of this saying, and in this blog we are going to break down the anatomical and functional significance of how the voice and pelvic floor mirror each other.

Let’s start by talking about some basic throat anatomy. The glottis is a hole on top of your trachea. The vocal cords sit on top of the glottis and are vibrated by airflow. The epiglottis, or “above glottis”, is an attachment point of the tongue. (See picture below). We’ve talked in previous blogs about the deep core as part of our pressure management system, but your glottis and nasopharyngeal system are also a part of our pressure system. A negative pressure in the thoracic cavity is what allows air to be drawn into our lungs on inhale, and the positive pressure expels the air on exhalation. In terms of our diaphragms, the epiglottic diaphragm works in similar fashion to the respiratory and pelvic diaphragms. When you take a breath in, there should naturally be a slight lowering of all of these diaphragms working together. As you exhale and expel air out, the diaphragms rise slightly.

Now let’s talk about function, as we know this may seem a little confusing and disconnected. We talk pretty regularly with women preparing for labor about the connection of the voice and pelvic floor. If you have ever had kids, you may have heard things like “Relax your jaw,” “Speak in low tones,” or “humm”. This is because lower tones and relaxing the muscles around your jaw will also help relax your pelvic floor. You may have even noticed your voice naturally getting deeper as labor progressed and the pelvic floor was widening. As the vocal folds open, pitch becomes lower. As the vocal folds move closer together, pitch gets higher. Because the epiglottic diaphragm mirrors the pelvic diaphragm, your pelvic floor is dropping down slightly as the pitch lowers. With higher tones, the pelvic floor is lifting. Having this information can arm you with some tools whether you are living with pelvic floor dysfunction, are pregnant or postpartum.

Let's go through a few more practical examples:

During pregnancy, your respiratory diaphragm will overwork as a postural muscle as the abdominal wall lengthens and pelvic floor assumes more load with growing baby.. If you have noticed any changes in your pitch and voice tone during and after birth, this is why. Singing in the postpartum phase is a great way to reintegrate the pelvic floor, diaphragm and voice.

If you are someone who lives with chronic pelvic pain, it may be helpful to try humming and speaking in low tones to downtrain the pelvic floor. Similarly, chronic neck/jaw/TMJ pain may be improved by working on your pelvic tone. They mirror each other, remember?

If you are someone who is constantly clearing your throat, you may have a coordination and lower pressure problem. Lower pressure issues of the respiratory diaphragm and pelvic floor can cause a deeper voice and an inability to clear your airway. Coughing and sneezing is an explosive force and may be compensatory in this case.

To sum up, your voice and pelvic floor have neurologic connections which cause them to work together and mirror each other. This connection can be altered due to injuries, chronic pain, stress, breath holding, pregnancy, etc. If you are having issues of low tone in your pelvic floor, you can add high pitched singing to your rehab program. If, on the other hand, you are dealing with a tight pelvic floor, use this information to your advantage and lower your pitch as much as you can. We hope this information was helpful for you. As always, seek out a pelvic floor therapist in your area if you want some more guidance in this area!

Health and Happiness,

Dr. Carly & Dr. Katie